POS0183 THE UPDATED CARDIOVASCULAR RISK ESTIMATION SCALE SCORE2 DOES NOT IMPROVE THE PRECISION IN PREDICTING CARDIOVASCULAR EVENTS IN PATIENTS WITH GOUT
Authors: M. D. C. López González, E. Tovar-Sugrañes, C. Rodríguez Alvear, E. Perea Martínez, M. Monzó, A. Avilés, M. Andrés
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Cardiovascular (CV) risk in gout is increased due to the accumulation of CV risk factors and persistent inflammation. Therefore, it is necessary to have precise evaluation strategies to categorize the risk of patients with gout in order to optimize their treatment. In previous studies, we have seen that the usual prediction scales SCORE and Framingham Heart Study are not accurate in detecting patients with gout and carotid atheroma plaques (PMID 28093417). The SCORE2 version, an update of the SCORE tool, performed similarly in predicting the presence of those plaques [1], although it remains unknown its predictive capacity of CV events in patients with gout. <h3>Objectives</h3> To evaluate the precision of SCORE2 in predicting CV events in patients with gout, with a comparison with prior SCORE and Framingham Heart Study tools. <h3>Methods</h3> We conducted a retrospective post-hoc study on new patients with crystal-proven gouts, from our inception cohort focused on evaluating their CV risk. The recruitment period was 2014-2018. For the present analysis, we selected patients eligible for SCORE2 calculation (without established CV disease, diabetes with vascular involvement or severe renal disease), and we collected the occurrence of a first major CV event (stroke, acute myocardial infarction (AMI), congestive heart failure (CHF), peripheral artery disease (PAD), and CV death) from their electronic records, occurring from study inclusion up to the event, end of follow-up or 03/31/2022. We calculated their incidence rate (IR) and evaluated the predictive capacity for CV events of SCORE 2, SCORE and REGICOR (Framingham equation calibrated for the Spanish population) (PMID: 2622955) tools using a Cox regression model that allows to estimate their hazard ratio with 95% confidence intervals (CI). <h3>Results</h3> Of the initial sample of 356 patients, 193 (54.2%) were selected for this analysis. They were mainly men (94.8%) of middle age (average 56.8 years), with an average of 8.2 years since the first gout flare. Almost all patients originate from low CV risk geographical regions, but only 32 patients (16.6%) classified at high risk by SCORE2. The median follow-up time was 6.4 years (p25-75 5.1-7.1). During the follow-up, 10 patients had a first CV event (3 cases of stroke, 2 of AMI, 2 of CHF, 2 of PA, and one patient died from a CV cause). The IR of CV events in this subset was 0.83 cases per 100 patient-years. In terms of predicting CV events in patients with gout, the SCORE2 tool did not show a better performance than the SCORE and REGICOR (Framingham) tools <b>(Table 1</b>). <h3>Conclusion</h3> The SCORE2 tool significate no improvement on accurately predicting CV events in patients with gout compared to previous SCORE and Framingham Heart Study scales. Our data should be replicated in regions with higher CV risk estimates. <h3>Reference</h3> [1]Tovar-Sugrañes E, et al. The Updated Cardiovascular Risk Tool SCORE2 Provides No Advantage in Identifying Patients with Gout and Carotid Atheroma Plaques [abstract]. Arthritis Rheumatol. 2022; 74 (suppl 9). <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.